Provider Demographics
NPI:1114265550
Name:CARE PERSONNEL HEALTHCARE
Entity Type:Organization
Organization Name:CARE PERSONNEL HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DIABATE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-579-5551
Mailing Address - Street 1:12101 NEW HAMPSHIRE AVE
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-2868
Mailing Address - Country:US
Mailing Address - Phone:301-579-5551
Mailing Address - Fax:301-579-5552
Practice Address - Street 1:12101 NEW HAMPSHIRE AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-2868
Practice Address - Country:US
Practice Address - Phone:301-579-5551
Practice Address - Fax:301-579-5552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-18
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR3044251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD4211405-00Medicaid